Global Handbook of Health Promotion Research, Vol. 3: Doing Health Promotion Research

360 Pages·2023·7.861 MB·English

by  Didier Jourdan, Louise Potvin

Didier Jourdan
Louise Potvin Editors
Global Handbook of
Health Promotion
Research, Vol. 3
Doing Health Promotion Research
Global Handbook of Health Promotion
Research, Vol. 3
Didier Jourdan • Louise Potvin
Editors
Global Handbook of Health
Promotion Research, Vol. 3
Doing Health Promotion Research
With Contributions by Valérie Ivassenko and Catherine Chabot
Editors
Didier Jourdan Louise Potvin
UNESCO Chair and WHO Collaborating School of Public Health
Centre Global Health and Education University of Montreal
Montreal, QC, Canada
National Institute of Teaching and
Education Centre de recherche en santé
University of Clermont Auvergne publique (CReSP)
Clermont-Ferrand, France University of Montreal and CIUSSS du
Centre-Sud-de-l’Île-de-Montréal
Montreal, QC, Canada
ISBN 978-3-031-20400-5 ISBN 978-3-031-20401-2 (eBook)
https://doi.org/10.1007/978-3-031-20401-2
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Foreword
Over the five decades of my career as a social scientist in public health as professor,
researcher and administrator I have been concerned with the methodology and scien-
tific rigor of the field of health promotion. From the earlier years (1972–1982) of
teaching graduate students in the behavioral sciences at the Johns Hopkins School of
Public Health, Department of Behavioral Sciences, I began to realize the lack of a
rigorous portfolio of research approaches to understanding the role of social and cul-
tural factors in health and illness. At that time the field of work called “health promo-
tion” was in its infancy. Later (1982–1992), as founding Director and Professor of the
research unit in health and behavioral change at the University of Edinburgh, I had the
opportunity to explore in considerable detail the need for better approaches in health
promotion research. Finally, as a senior biomedical research scientist and associate
director for Global Health Promotion at the CDC National Center for Chronic Disease
and Health Promotion, I had two decades to explore and promote the needs for more
rigorous research in health promotion. It was clear from the beginning of this explora-
tion for the best research methods in health promotion that the field was open to a
broad spectrum of research approaches drawing on all the relevant social sciences
from anthropology to sociology. It was also clear that the more traditional biomedical
methodologies applied in much of public health were not up to the task of being the
appropriate basis for advancing the understanding of the health promotion field. It is
within this context that two decades ago I met and was impressed by an up-and-
coming researcher at the University of Montréal, Louise Potvin. Over the years, we
collaborated on several vital research books and articles.
Now Louise Potvin and Didier Jourdan have assembled a collection of papers that
address the most salient challenges in health promotion research and at the same time
reflect the significant development of the field in the last 50 years. Collectively, they
reflect the recognition that health promotion research needs distinctive and innovative
approaches. Partly because health promotion, in my view, did not develop a strong
disciplinary-based paradigm or a fundamental epistemological base, the field requires
some thoughtful and versatile approaches to providing a research base. As a field of
practice and research, health promotion is multidisciplinary and complex, thus
demanding highly varied and sometimes novel approaches. The classical research
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vi Foreword
notions of proof, evidence and rigor that have debatably informed the so-called hard
sciences are a significant challenge in health promotion research but are also often
inappropriate in health promotion. The field needs its own research base.
Throughout this publication, one sees the many unique approaches to research
that have been applied and developed by leading researchers in health promotion.
There are two broad aspects of health promotion that have been developed signifi-
cantly over the past few decades, notably attention to a broader view of research
strategies and a broadened view of the variables that are critical to health promo-
tion research and development of a sound basis for a health promotion theoretical
perspective. I would still assert that health promotion lacks a coherent and well-
developed theoretical underpinning. However, the development of a sound
research base, in my view, will lead to an emergent theoretical base.
The key research strategies that have developed significantly in past 20–30 years
are the usage of critical realism, participatory-based research, mixed methods, and
the realization that health promotion research requires some fundamentally differ-
ent thinking from that of many other areas related to health. It is simply not cogent
to just see the methods debate as one between quantitative and qualitative methods.
Health promotion research has clearly shown that the appropriate methodologies
arise from the practice of health promotion itself and that approaches are guided by
an effort to decide how best to acquire a knowledge base for health promotion prac-
tice. This is evident in the wide range of methods discussed in this book.
The research methods that have developed in health promotion are in part because
of the emergence of key variables, or what may also be thought of as the “subject mat-
ters” of health promotion. There are many that have evolved over the years, but they
revolve around the key questions of what is health, what creates health, what damages
health, and what can be done to change health over time. Furthermore, the answers lie
in a mixture of individual and social behaviors, social context, and a complex inter-
play between all of the variables that make up the study of health promotion. As a
result, we have seen intense concern with notions such as equity, marginalization, and
policy to name just three of the many relevant concerns that are researched.
The development of research methods and the broadening field of health promo-
tion practice have not made it easy to develop a singular recognizable and authorita-
tive research approach to health promotion. One could probably argue that research
in health promotion is still in its infancy. But, infant or not, Potvin and Jourdan have
assembled a comprehensive overview of the current state of the art. Clearly, anyone
who is a researcher in this area or aspires to be one has much to gain by the insights
offered in this publication. Now, in partial retirement, I am most pleased to endorse
and admire this new publication on research edited by Drs. Potvin and Jourdan.
Prof. Dr. David V. McQueen
Editor-in-Chief, Oxford Research Encyclopedia of Global Public Health, Oxford
University Press
Adjunct Professor of Social and Preventive Medicine, Institute of Social and
Preventive Medicine, Universität Bern, Bern, Switzerland
Recipient 2021, Jacques Parisot Award, Lifetime Achievement Award in Health
Promotion
February 14, 2022
Preface
The project of creating a handbook of health promotion research was launched
through an open call for proposals in March 2020. This date will resonate for most
of us as the time humanity entered the unknown-but-yet-familiar world of SARS-
CoV- 2. It was familiar because humanity has dealt with epidemics since its infancy
as its evolution has always been accompanied by viruses and bacteria. However, it
was also unknown as the medical revolution of the twentieth century has led us to
believe that communicable diseases were things of the past, or at least phenomena
that our arsenal of vaccines, technology and protective equipment could quickly
circumscribe and even eradicate before it reaches the whole population. It was also
unknown because for the first time in history, humanity could watch in real time,
and mostly defenseless, the progression of the epidemic towards a deadly global
pandemic, leaving no one sheltered. Two years later, at the time of writing these
lines, counting 13–17 million deaths to COVID-19 and watching yet another war
but this time involving countries with nuclear capacity, humanity is again facing an
unknown-but-still-yet-familiar situation.
During the past two years, we have witnessed how science can be harnessed to
address complex problems. The development in less than a year of a range of vac-
cines to protect against a previously unknown virus has been celebrated as one of
the great achievements of science, made possible by the general mobilisation of
resources and brains. We have also witnessed that having a technical solution at
hand is not the end of the story. In addition to knowledge about the virus and human
and animal immune systems, the implementation of such solutions necessitates
other specialised knowledge, this time about humans; about the psychological, soci-
ological, political, economical and other impacts of organising collective life in
order to live with the virus while protecting the most vulnerable among us. This is
just one example of the increasing complexity of the problems we face that calls for
multidimensional solutions. Health promotion research is one field of science that
pursues the ambition to provide relevant knowledge to address complex population
health problems from the local to the global level.
At the confluence of biomedical, education and social sciences traditions, “doing
health promotion research” often means having to justify the validity of one’s
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viii Preface
epistemological, ethical and methodological choices in the contested arena of inter-
disciplinary research. Indeed, the challenges raised by the objects of study and by
the epistemological and ethical orientations specific to health promotion research
have led researchers to innovate and adapt practices from a diversity of scientific
traditions to find scientifically valid and socially acceptable solutions to those chal-
lenges. Doing so often means exploring various literatures from different fields in
which the specific problem at hand is rarely formulated in a way that is readily
accessible. Having engaged in health promotion research on several continents for
the past 40 years or so, the editors of this handbook have had a long experience of
such explorations and adaptations. Combined, the total number of graduate stu-
dents, postdoctoral fellows and research staff that one or the other has mentored
over these years amounts to more than 200. We know how tedious and unrewarding
this process can be, especially for those who are still in the early stages of their
research career.
We embarked on this project of collating a unique collection of paradigms,
approaches and methods relevant and specifically adapted to health promotion
research, so as to support health promotion researchers of all horizons to find solu-
tions to research-related challenges. Written by those who have designed these
research innovations or introduced them in the field of health promotion, these
chapters are formulated as ways to address specific issues in health promotion
research. These chapters are also written as introductions to those research compo-
nents so as to familiarise researchers with their fundamental concepts and the prac-
tices supporting their implementation. They constitute as many points of entry to
research approaches, paradigms, designs and methods that support “doing health
promotion research”. They will ease the way to more in-depth forays for those inter-
ested. This is in part why this handbook is constructed as a tool kit. Three features
will help users find the right tool for their problem.
First, we organised the volume in six parts. Part I relates to the paradigms and
approaches relevant to health promotion research. Parts II–V present research
designs and methods that specifically address epistemological challenges in health
promotion research. Part VI is the conclusion of the volume.
Second, we ask authors to provide definitions of the core concepts underlying
their presentation. This is not exactly a glossary, as it is not systematic and some
terms are defined in more than one chapter. It is, however, a way to quickly capture
the essence of the paradigm, approach or method discussed in a given chapter. These
terms were also used in the index at the end of the volume.
Third, we created an extended table of contents that can be found at the end of
the book (see Appendix: Overview of the Chapters). The short summary associated
with each chapter captures the health promotion research issue the chapter used as
a point of entry, the essence of the approach or research design presented and why
it contributes to health promotion research.
Preface ix
We have argued elsewhere that health promotion research has come of age and
that it is time to claim and structure a distinct field in the scientific landscape.
Because it presents epistemological and practical solutions to problems distinctive
of health promotion research, this volume is a cornerstone on which to further
develop tools specific to health promotion research.
Montréal, Québec, Canada Louise Potvin
Clermont-Ferrand, France Didier Jourdan

June 2022
Contents
1 A Global Participatory Process to Structuring the Field of Health
Promotion Research: An Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 1
Louise Potvin and Didier Jourdan
2 Doing Health Promotion Research: Approaches, Paradigms,
Designs and Methods to Produce Knowledge . . . . . . . . . . . . . . . . . . . . 11
Didier Jourdan and Louise Potvin
Part I Approaches to Knowledge Production in Health
Promotion Research
3 Health Promotion Political Research as Policy Practice . . . . . . . . . . . 23
Evelyne de Leeuw
4 Underlying Principles of Different Schools of Economic
Thought: Consequences for Health Promotion Research . . . . . . . . . . 39
Alan Shiell, Hannah Jackson, and Penelope Hawe
5 Critical Realism for Health Promotion Evaluation . . . . . . . . . . . . . . . 49
Sarah Louart and Valéry Ridde
6 Empowerment in Health Promotion of Marginalised Groups:
The Use of Paulo Freire’s Theoretical Approach and
Community-Based Participatory Research for Health Equity . . . . . . 61
Andrea Rodriguez and Nilza Rogeria de Andrade Nunes
7 Health Promotion in Primary Care: Michel Foucault’s
Genealogy to Analyse Changes in Practices . . . . . . . . . . . . . . . . . . . . . 69
Fernanda Carlise Mattioni and Cristianne Maria Famer Rocha
8 Health Promotion as a Complex Assemblage: Science
and Technology Studies as Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Peter Kelly and Kerry Montero
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